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Lymph nodes in the neck can become painful for a variety of reasons, including infectious and noninfectious. Read more below to learn about associated symptoms, possible causes, and treatment options for painful lymph nodes in the neck.
7 most common causes
Neck pain along the lymph nodes symptoms
The lymphatic system is an import network of organs, vessels, and glands throughout the body important for immune function. The glands of the system, called lymph nodes, function to filter and trap viruses, bacteria and other pathogens before they can spread and infect other parts of the body. They play an important role in your body's ability to fight infection and often swell in the setting of inflammatory conditions.
The neck has multiple lymph nodes (cervical lymph nodes) that can become painful due to a variety of conditions. See this image for a visual representation of the multiple lymph nodes within the neck area and lower face.
Common accompanying symptoms of neck pain along the lymph nodes
In addition to pain along the lymph nodes, you may experience symptoms such as:
- Sore throat
- Drainage (also called rhinorrhea)
- Night sweats
- Shortness of breath
- Palpable bump or lumps along the neck
Neck pain along the lymph nodes is usually a sign of an underlying condition, so it is important to follow-up with a healthcare professional promptly.
Neck pain along the lymph nodes causes
Neck pain along the lymph nodes can be caused by enlargement of the lymph nodes (lymphadenopathy) or inflammation of the lymph nodes (lymphadenitis). Traditionally, infectious etiologies are the main cause of lymphadenitis. Noninfectious etiologies are usually the main cause of lymphadenopathy; however, there can be overlap. Acute causes of lymphadenitis develop over a couple of days and can be very noticeable. These conditions are usually followed-up more promptly than chronic conditions that take time to develop. However, it is important to take note of any symptoms of pain and associated symptoms over time in order to get proper care.
Infectious causes of neck pain along the lymph nodes can be acute (developing over a few days) or chronic (developing over weeks or months) and can happen on both sides of the neck (bilaterally) or on one side (unilateral).
- Acute: Acute infectious causes are often those related to viral or bacterial pathogens. Many upper respiratory viruses such as adenovirus, influenza virus and enterovirus often cause lymphadenitis and associated symptoms such as a cough, congestion, and sore throat. Streptococcus is a bacterial infection that can cause pharyngitis and lymphadenitis that is often very tender.
- Chronic: Chronic infectious causes are most often related to viral infections such as Epstein-Barr virus (EBV) and more serious viral infections such as HIV. There are also less common bacterial pathogens that can cause lymphadenitis such as tuberculosis.
Noninfectious causes of neck pain along the lymph nodes can occur similarly as above, acutely or chronically and bilaterally or unilaterally.
- Acute: Acute noninfectious causes of lymphadenopathy or lymphadenitis are inflammatory conditions that are not associated withinfection. In children, illnesses such as Kawasaki disease is a type of vasculitis (inflammation of the blood vessels) that occurs in childhood. A characteristic manifestation of this condition is lymphadenopathy.
- Chronic: Many noninfectious chronic causes of neck pain along the lymph nodes are associated with cancerous processes. For example, cancers of the lymphatic system, called lymphomas, can occur in many different types. Lymphomas often occur in the lymph nodes of the neck and can grow very rapidly, causing massive swelling, and are associated with symptoms of fatigue, night sweats, and unintentional weight loss.
This list does not constitute medical advice and may not accurately represent what you have.
Retropharyngeal abscess (adult)
Retropharyngeal abscess is a collection of pus in the tissues in the back of the throat. It is a potentially life-threatening medical condition.
Rarity: Ultra rare
Top Symptoms: sore throat, loss of appetite, fever, shortness of breath, being severely ill
Urgency: Hospital emergency room
A skin abscess is a large pocket of pus that has formed just beneath the skin. It is caused by bacteria getting under the skin, usually through a small cut or scratch, and beginning to multiply. The body fights the invasion with white blood cells, which kill some of the infected tissue but form pus within the cavity that remains.
Symptoms include a large, red, swollen, painful lump of pus anywhere on the body beneath the skin. There may be fever, chills, and body aches from the infection.
If not treated, there is the risk of an abscess enlarging, spreading, and causing serious illness.
Diagnosis is made through physical examination.
A small abscess may heal on its own, through the body's immune system. But some will need to be drained or lanced in a medical provider's office so that the pus can be cleaned out. Antibiotics are usually prescribed.
Keeping the skin clean, and using only clean clothes and towels, will help to make sure that the abscess does not recur.
Myofascial pain syndrome
Myofascial pain syndrome is also called chronic myofascial pain (CMP.) Pressure on certain points of the muscles causes referred pain, meaning the pain is felt elsewhere in the body.
The cause is believed to be muscle injury through overuse, either from sports or from a job requiring repetitive motion. Tension, stress, and poor posture can also cause habitual tightening of the muscles, a form of overuse.
This overuse causes scar tissue, or adhesions, to form in the muscles. These points are known as trigger points, since they trigger pain at any stimulus.
Symptoms include deep, aching muscular pain that does not go away with rest or massage, but may actually worsen. There is often difficulty sleeping due to pain.
Myofascial pain syndrome should be seen by a medical provider, since it can develop into a similar but more severe condition called fibromyalgia.
Diagnosis is made through physical examination and applying mild pressure to locate the trigger points.
Treatment involves physical therapy, pain medications, and trigger point injections. In some cases, acupuncture and antidepressants are helpful.
Top Symptoms: dizziness, spontaneous shoulder pain, pain in the back of the neck, tender muscle knot, general numbness
Symptoms that always occur with myofascial pain syndrome: tender muscle knot
Urgency: Primary care doctor
Lymph node inflammation behind the ear
There are lymph nodes behind the ear. Lymph nodes are where your immune cells live, and when they become enlarged, it could be from a nearby infection, immune response, or even backlog of blood.
You should see your primary care doctor tomorrow for a sick visit. There, the doctor can look at what could explain the enlarged node behind your ear.
Top Symptoms: pain behind the ear, swelling behind the ears
Symptoms that always occur with lymph node inflammation behind the ear: swelling behind the ears
Urgency: Primary care doctor
Fibromyalgia is a set of chronic symptoms that include ongoing fatigue, diffuse tenderness to touch, musculoskeletal pain, and usually some degree of depression.
The cause is not known. When fibromyalgia appears, it is usually after a stressful physical or emotional event such as an automobile accident or a divorce. It may include a genetic component where the person experiences normal sensation as pain.
Almost 90% of fibromyalgia sufferers are women. Anyone with rheumatic disease, such as rheumatoid arthritis or lupus, may be more prone to fibromyalgia.
Poor sleep is often a symptom, along with foggy thinking, headaches, painful menstrual periods, and increased sensitivity to heat, cold, bright lights, and loud noises.
There is no standard test for fibromyalgia. The diagnosis is usually made when the above symptoms go on for three months or more with no apparent cause.
Fibromyalgia does not go away on its own but does not get worse, either.
Treatment involves easing symptoms and improving the patient's quality of life through pain medications, exercise, improved diet, and help with managing stressful situations.
Top Symptoms: fatigue, arthralgias or myalgias, anxiety, depressed mood, headache
Symptoms that always occur with fibromyalgia: arthralgias or myalgias
Urgency: Primary care doctor
Enlarged lymph nodes in the neck
Enlarged lymph nodes occur when the node becomes larger as it fills with inflammatory cells. This often is a result of an infection but can occur without a known cause.
You should discuss with a health care provider whether or not your lymph node needs to be checked. Enlarged lymph nodes will usually shrink on their own. To speed up the process, try applying a warm, wet compress to the affected area.
Top Symptoms: neck bump, movable neck lump
Symptoms that always occur with enlarged lymph nodes in the neck: neck bump
Symptoms that never occur with enlarged lymph nodes in the neck: unintentional weight loss, fever, hard neck lump
Urgency: Phone call or in-person visit
Acute thyroiditis is a rare inflammation of the thyroid gland caused by an infection, radiation, medication, or trauma.
You should seek immediate medical care at an ER. This is possibly a medical emergency and requires immediate diagnosis (thyroid function tests, blood tests, and imaging) and treatment (antibiotics, supportive care, stopping causative drugs).
Rarity: Ultra rare
Top Symptoms: sore throat, fever, being severely ill, hoarse voice, pain in the front of the neck
Symptoms that always occur with acute thyroiditis: pain in the front of the neck
Urgency: Hospital emergency room
Neck pain along the lymph nodes treatments and relief
When to see a doctor for neck pain along the lymph nodes
Treatment for neck pain along the lymph nodes will depend on the specific cause. Your healthcare provider may make the following suggestions/treatments in the setting of neck swelling.
- Antibiotics: If your symptoms are due to a bacterial cause, your physician will prescribe the appropriate antibiotics.
- Supportive care: Many causes of enlarged lymph nodes may be viral in nature. Viral causes will not resolve with antibiotics, and your physician will most likely suggest supportive remedies, such as resting or pain relief if that is the case.
- Cancer treatment: Lymphoma treatment may involve chemotherapy, immunotherapy medications, radiation therapy, a bone marrow transplant or some combination of these. Other cancer treatments involve similar treatment modalities as well.
Since bacterial and viral infections are the main cause of neck pain along the lymph nodes, there are many things you can do in order to prevent infection and stop symptoms from occurring. These strategies include:
- Washing your hands regularly with soap and water
- Covering coughs and sneezes with the elbow or sleeve and not the hands
- Avoiding those who are ill
- Avoiding touching the face, nose, eyes, and mouth with unwashed hands
FAQs about neck pain along the lymph nodes
What does it mean when the lymph nodes hurt?
Painful lymph nodes are usually a sign of acute or chronic infection and sometimes noninfectious causes such as cancer or autoimmune disease. Lymph nodes function to filter and trap viruses, bacteria and other pathogens before they can spread and infect other parts of the body. Often pain and other associated symptoms are the first sign that an underlying infection or process is occurring.
Why do the lymph nodes become painful due to these different causes?
The pathophysiology of cervical lymphadenitis (inflammation of the lymph nodes) is not completely understood; however, it is thought that it is in relation to the penetration of the microorganisms into the skin of the neck that are transported by lymph vessels to the lymph nodes .
How long will the pain along my lymph nodes last?
The duration of the pain will depend on the root cause. For example, painful and swollen lymph nodes due to infectious causes often resolve once the illness resolves. With causes that are related to the cancerous or chronic processes, the resolution is often dependent on a specific treatment.
Does lymphoma spread quickly?
Lymphomas can be divided into different types. The most common categorizations are Non-Hodgkin Lymphoma vs. Hodgkin lymphoma. Hodgkin lymphomas can often spread very quickly and the signs and associated symptoms, such as night sweats or weight loss, can be very severe .
Does lymphoma go into remission?
According to Lymphoma-action.org, lymphoma will never relapse in most people after successful treatment. The goal of treatment, especially for low-grade lymphomas, is remission. If you have a good remission, you are likely to have a longer time before your lymphoma relapses.
Questions your doctor may ask about neck pain along the lymph nodes
- Do you notice your heart beating hard, rapidly, or irregularly (also called palpitations)?
- Have you ever been told you have a heart valve problem?
- Have there been changes in your voice?
- Do you have a sore throat?
Self-diagnose with our free Buoy Assistant if you answer yes on any of these questions.
Neck pain along the lymph nodes statistics
People who have experienced neck pain along the lymph nodes have also experienced:
- 10% Neck Bump
- 7% Sore Throat
- 4% Fatigue
People who have experienced neck pain along the lymph nodes were most often matched with:
- 54% Acute Thyroiditis
- 27% Fibromyalgia
- 18% Enlarged Lymph Nodes In The Neck
People who have experienced neck pain along the lymph nodes had symptoms persist for:
- 37% Less than a week
- 26% Less than a day
- 18% Over a month
Source: Aggregated and anonymized results from Buoy Assistant (a.k.a. the quiz).
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- Kawasaki disease. American Heart Association. Reviewed May 31, 2017. AHA Link
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- Adult Hodgkin Lymphoma Treatment (PDQ) Patient Version. National Cancer Institute. Updated Oct. 19, 2018. National Cancer Institute Link
- Mack MG, Rieger J, Baghi M, Bisdas S, Vogl TJ. Cervical lymph nodes. Eur J Radiol. 2008;66(3):493-500. PubMed Link